University Pediatric Associates welcomes new patients. Choosing the right pediatrician for your child is one of the most important decisions you will make. By selecting University Pediatric Associates, you can feel confident and comfortable that you have made the right decision.
To understand what to expect for your child's first visit to our practice, please read through this page.
Our practice is working together to build life-long relationships between our staff and our patients by consistently providing our patients with compassion, excellence, and value. To fulfill this mission, we are committed to:
- Improving the lives of the children we serve by providing quality care in a child-centered environment.
- Listening to our young patients and their families who we are privileged to serve.
- Guiding our patients along a path of optimal health and wellness.
- Continually pursuing excellence at all levels through continuing education.
We work hard to ensure that your child receives prompt medical care in a comfortable, child-friendly office setting. To help expedite the first appointment, we ask that you please bring your child's immunization records and be prepared to complete paperwork regarding your family medical history, your child's medical history, and insurance information.
We are also happy to offer you the option to download, print and complete our office forms to reduce wait times during your first appointment.
- New Patient Forms
- Immunization Schedule
- Universal Child Health Record
- Preparticipation Physical Evaluation Form
- Health History Updated Questionnaire_6-12-20
- Vanderbilt Parent Form
- Vanderbilt Teacher Form
- Permission to Authorize Treatment
- Authorization to Release Medical Information (leaving) [pdf] [secured online form]
- Transfer Your Child's Medical Records to UPA [pdf] [secured online form]
- Yearly Update for Current Patients [pdf] [secured online form]
- 18 year old Consent form [pdf] [secured online form]
- UPA Financial Policy 2018 [pdf] [secured online form]
- Privacy and Insurance Authorization [pdf] [secured online form]
- HIPPA Laws
In order to view or print these forms you will need Adobe Acrobat Reader installed. Click here to download it.
What to Expect
On the day of your child's first visit to our office, we recommend arriving a few minutes early. This allows extra time for finishing up any registration forms and ensures you have plenty of time to get acquainted with our staff and office. We look forward to meeting you and joining with you to help your child maintain optimal health.